- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,027.60 / $15,795.00 / $18,210.70
| Facility | | $13,027.60 | $15,795.00 | $18,210.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,747.03 / $19,848.56 / $24,023.97
| Facility | | $16,747.03 | $19,848.56 | $24,023.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,588.98 / $18,446.46 / $31,659.89
| Facility | | $11,588.98 | $18,446.46 | $31,659.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $18,317.45 / $27,875.49
| Facility | | $3,137.00 | $18,317.45 | $27,875.49 |